Shemesh S, Kosashvili Y, Sidon E, Fichman S, Cohen N, Velkes S
Departments of Orthopedics, Rabin Medical Center, Petach Tikva 49100 and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
Departments of Pathology, Rabin Medical Center, Petach Tikva 49100 and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
J Bone Oncol. 2014 Sep 30;3(3-4):80-3. doi: 10.1016/j.jbo.2014.06.002. eCollection 2014 Nov.
Myofibromas are mesenchymal tumors showing myofibroblastic differentiation and found most frequently in the head and neck region. While several cases of myofibromas have been reported in adults, they have not been described in long bones of the appendicular skeleton. We describe an otherwise healthy young woman who presented with a progressive incapacitating pain in her right shin. Imaging studies revealed a well-circumscribed osteolytic lesion with slight marginal sclerosis confined to the proximal tibia metaphysis, without a soft tissue component. Surgical intervention was performed and histological examination identified a myofibroma. This case represents an extremely rare occurrence of an intraosseous myofibroma involving a long bone in an adult patient. Although solitary myofibroma is a rare lesion in the skeletal bones of adults we believe it should be included in the differential diagnosis of a solitary lytic mass in bone, especially if it is associated with pain.
肌纤维瘤是一种间叶组织肿瘤,表现为肌成纤维细胞分化,最常发生于头颈部区域。虽然已有数例成人肌纤维瘤的报道,但在四肢骨骼的长骨中尚未见相关描述。我们报告了一名身体健康的年轻女性,她右小腿出现进行性致残性疼痛。影像学检查显示,在胫骨近端干骺端有一个边界清晰的溶骨性病变,伴有轻微边缘硬化,无软组织成分。进行了手术干预,组织学检查确诊为肌纤维瘤。该病例代表了成年患者长骨内骨内肌纤维瘤极为罕见的发生情况。尽管孤立性肌纤维瘤在成人骨骼中是一种罕见病变,但我们认为在鉴别诊断骨内孤立性溶骨性肿块时应将其纳入考虑,尤其是伴有疼痛时。